PROJECT SUMMARY: TRIBAL EQUINE ASSISTED PSYCHOTHERAPY: BUILDING YOUTH RESILIENCY THROUGH HORSES The overall goal of this pilot research project is to test the efficacy of an Equine Assisted Psychotherapy (EAP) intervention with at-risk American Indian/Alaska Native (AI/AN) adolescents and develop a culturally informed EAP implementation guide for use in tribal settings. The proposal addresses persistent and well- documented disparities in mental and behavioral health outcomes among AI/AN adolescents. Currently, few culturally-informed treatments for AI/AN adolescents suffering from mental health concerns exist. EAP is an emerging alternative to traditional evidence-based behavioral health practice, and may be an especially promising alternative in rural AI/AN communities where horses are inextricably linked to AI/AN identity, culture and tradition. This pilot study addresses gaps in scientific knowledge and practice by exploring the impact of EAP upon resiliency and self-efficacy among AI/AN adolescents in two Southwest Tribes. Our primary hypothesis is that by embedding a culturally-defined EAP intervention within existing tribal behavioral health programs, resiliency and self-efficacy among at-risk AI/AN adolescents will increase. We plan to test our central hypothesis and thereby accomplish the overall study objective by pursuing the following specific aims: Aim 1: Conduct an efficacy trial to test the additive benefits of Equine Assisted Psychotherapy upon resilience and self-efficacy among at-risk AI/AN adolescents (age 12-18) compared to standard intervention alone. Aim 2: Use qualitative methods to elucidate determinants that facilitate or constrain the implementation of EAP in tribal settings, including important cultural and contextual considerations that will be incorporated into an EAP tribal implementation guide to promote the replication and further study of EAP treatment in AI/AN communities. The outcomes of this pilot study are expected to have an important positive impact towards establishing a culturally-informed EAP model that can bolster resiliency and self-efficacy and reduce disparities in health risk behaviors among AI/AN adolescents.